Significance of admission hypoalbuminemia in acute intracerebral hemorrhage.
Significance of admission hypoalbuminemia in acute intracerebral hemorrhage.
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DOI：
10.1007/s00415-017-8451-x
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发表时间：
2017-05
影响因子：
6
通讯作者：
Goldstein JN
中科院分区：
文献类型：
--
作者：
Morotti A;Marini S;Lena UK;Crawford K;Schwab K;Kourkoulis C;Ayres AM;Edip Gurol M;Viswanathan A;Greenberg SM;Anderson CD;Rosand J;Goldstein JN
低水平的血清白蛋白可能会增加重症患者的感染风险和死亡率。我们检验了入院时低白蛋白血症预测急性脑出血（ICH）患者感染并发症和不良预后的假设。我们分析了1994年至2015年期间收集的ICH患者的单中心队列。根据经验证的标准，回顾性确定了肺炎、尿路感染和脓毒症。入院时测量血清白蛋白，低白蛋白血症定义为总白蛋白≤ 3.5 g/dL。用多变量逻辑回归分析检验白蛋白水平、感染和90天时死亡率之间的关系。共纳入2010例患者（中位年龄74岁，54.5%为男性），其中444例（22.1%）在入院时患有低白蛋白血症，763例（38%）在90天内死亡。肺炎、尿路感染和脓毒症的发生率分别为19.9%、15.1%和2.7%。低白蛋白血症患者入院时格拉斯哥昏迷评分较低，脑室内出血发生率较高，且更可能有慢性肾脏或肝脏疾病史。校正潜在混杂因素后，低白蛋白血症是肺炎（比值比[OR] 1.76，95%置信区间[CI] 1.34-2.33，p <0.001）和脓毒症（OR 2.29，95% CI 1.22-4.30，p=0.010）的独立预测因子。低水平的白蛋白也与90天时较高的死亡率独立相关（OR 1.78，95%CI 1.30-2.44，p<0.001）。总之，早期低白蛋白血症在ICH患者中很常见，预示预后不良。对肺炎和败血症的易感性增加可能是这种关联的病理生理机制。
Low levels of serum albumin may increase the risk of infections and mortality in critically ill patients. We tested the hypothesis that admission hypoalbuminemia predicted infectious complications and poor outcome in subjects with acute intracerebral hemorrhage (ICH). We analyzed a single center cohort of ICH patients collected between 1994 and 2015. Pneumonia, urinary tract infection and sepsis were retrospectively identified, according to validated criteria. Serum albumin was measured on admission and hypoalbuminemia was defined as total albumin ≤ 3.5 g/dL. The association between albumin levels, infections and mortality at 90 days was tested with multivariable logistic regression analyses. A total of 2010 patients were included (median age 74 years, 54.5% males) of whom 444 (22.1%) had hypoalbuminemia on admission and 763 (38%) died within 90 days. The frequency of pneumonia, urinary tract infection and sepsis was 19.9%, 15.1% and 2.7% respectively. Hypoalbuminemic patients had lower admission Glasgow coma scale, higher frequency of intraventricular hemorrhage and were more likely to have a history of chronic kidney or liver disease. After adjustment for potential confounders, hypoalbuminemia was an independent predictor of pneumonia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.34-2.33, p <0.001) and sepsis (OR 2.29, 95% CI 1.22-4.30, p=0.010). Low levels of albumin were also independently associated with higher mortality at 90 days (OR 1.78, 95% CI 1.30-2.44, p<0.001). In conclusion, early hypoalbuminemia is common and predicts poor outcome in ICH patients. Increased susceptibility to pneumonia and sepsis may be the pathophysiological mechanism underlying this association.
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影响因子：
1.2
作者：
Morotti, Andrea;Goldstein, Joshua N.
通讯作者：
Goldstein, Joshua N.
影响因子：
8.3
作者：
Hemphill, JC;Bonovich, DC;Johnston, SC
通讯作者：
Johnston, SC
DOI：
10.1164/ajrccm.162.4.9910106
发表时间：
2000-10-01
影响因子：
24.7
作者：
Cantin, AM;Paquette, B;Larivée, P
通讯作者：
Larivée, P
影响因子：
8.3
作者：
Belayev, L;Saul, I;Ginsberg, MD
通讯作者：
Ginsberg, MD
DOI：
10.1111/j.1532-5415.1983.tb03391.x
发表时间：
1983-01-01
影响因子：
6.3
作者：
KATZ, S
通讯作者：
KATZ, S